Talking Points

Medicaid is Vital to Children's Health

As Congress considers Medicaid proposals, it is imperative that any reforms maintain a sustainable, viable Medicaid program for children and protect children's access to care.
The Medicaid program is vital to ensuring access to care for America's children. Medicaid is the single largest health insurer for children in the United States. Children account for half of all Medicaid beneficiaries. Medicaid, along with the Children's Health Insurance Program (CHIP), is the foundation of America's commitment to providing coverage and access to care for children. Combined, the two programs provided coverage to more than 35 million children in FY 2014.

Children's hospitals play a central role in caring for the pediatric Medicaid population. On average, 52 percent of patients at a children's hospital are enrolled in Medicaid, compared to 16 percent of patients for all other hospitals. Children covered by Medicaid represent 56 percent of all inpatient days and 49 percent of all outpatient visits.
It is also important that Congress consider the federal-state partnership structure of Medicaid. Fundamental changes to the financing or structure of the program, such as proposals to cap federal support for Medicaid, have the potential to shift costs, which could force states to reduce benefits or cut already low provider rates and undermine states' ability to maintain children's access to care.

The key to making Medicaid work for children, especially those with complex medical conditions, is a framework that supports the sharing of data, clinical standards and quality measures designed for this population. Children's hospitals are piloting scalable solutions that will not only cut costs, but also improve care for children with medical complexity.